| NPI | 1215600374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL 26266) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: FL DN26266) |
| Enumeration Date | 2021-07-26 |
| Last Update Date | 2024-03-12 |